I'm transgender and just got top surgery. Afraid the nipple is dying. What do they do once the nipple dies? (Photo)

If it is still very soon into your #healing, your incisions and #nipples will go through a maturation #process. For the first few months they will be red and possibly raised and/or firm. As the scar matures, after 6-12 months, it becomes soft, pale, flat, and much less noticeable. You may experience numbness, tingling, burning, “crawling”, or other peculiar sensations around the surgical area. This is a result of the #healing of tiny fibers which are trapped in the incision site. These symptoms will disappear. Some people are prone to keloids, which is an abnormal scar that becomes prominent. If you or a blood relative has a tendency to keloid formation, please inform the doctor.
Bruising and #swelling are normal and usually increase slightly after the removal of any tape or foam. The bruising will decrease over 3-4 weeks, but may last as long as 6 weeks. The majority of the swelling will be gone within the first 3-4 weeks. However, it may take 6-9 weeks to disappear completely. Also, as you heal, the area may feel “lumpy” and irregular. This, too, decreases with time, and massaging these areas will help soften the scar tissue. The #compression garment helps reduce the swelling, and the longer it is worn, the more quickly you will #heal. It can also assist in the retraction of the skin. If you have any concerns about #healing, its best to ask questions of your surgeon or their nursing staff.

Thank you for your question. It is still early to determine how the nipple is going to finally heal. While it does appear as though there may be some delayed take often the top layer will come off and the underlying layer may be intact. Definitely give this more time. Keep the site covered and discuss with your PS if there are any other interventions they recommend. 

From your photo and without a history it is difficult to discern as to whether of not the nipple is surviving. It may be that given time, this will look a bit more normal.You should contact your surgeon and discuss your concerns. In the unfortunate case where there is no residual nipple, the are techniques that can be employed to reconstruct the nipple.Steven Turkeltaub, MD